- Select Medical (New York, NY)
- …an ICU or post-surgical stay by utilizing your strong clinical background, payer knowledge and problem-solving skills. + Perform clinical assessments of referred ... physicians to create a smooth pre-admissions and transfer processes through removing payer -related and operational barriers for the patients getting into our highly… more
- Adecco US, Inc. (New York, NY)
- …manufacturer partners to resolve reimbursement challenges and deliver critical education on payer landscapes and available support services. The FRM acts as a ... Education (25%)** - Educate providers on benefit verification, prior authorization, payer trends, and support center services. Document and report all interactions… more
- University of Rochester (Rochester, NY)
- …compliance with State and Federal Regulations, accreditation standards and third-party payer requirements for the purpose of minimizing risk and exposure. This ... business, market growth, service development and payor/PBM strategies. + Participates with payer contracting leaders of the health system in the evaluation and… more
- University of Rochester (Albany, NY)
- …are not limited to, independent research, claim correction and resubmission, handling payer specific appeal process taking timely and routine action to resolve ... accurate billing. Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of… more
- University of Rochester (Rochester, NY)
- …Chair of Medicine's Office for all faculty appointments, hospital privileging, and payer credentialing- - - Ensure completion of all requirements for timely ... new faculty, interviewing, contracts/recruitment, faculty appointment, hospital privileging, and payer credentialing Other Duties as assigned: - Supports seasonal… more
- University of Rochester (Rochester, NY)
- …not covered. + Determine if home infusion therapy being ordered meets payer requirements for coverage. Retrieve and assemble necessary information for insurance ... patient documentation. Coordinate required information for denied claims. Participate in payer audits and collect, summarize and send requested information. +… more
- Cardinal Health (Albany, NY)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... timely manner. The Coordinator, Individualized mediates effective resolution for complex payer /pharmacy issues toward a positive outcome and provides a positive… more
- The Institute for Family Health (New Paltz, NY)
- …vendors}) + Ensures smooth operations with clearinghouse vendor and facilitates payer requirements as needed for electronic claims processing and retrieval of ... 28, Article 31, dental CMS, managed care, sliding fee, and commercial payer billing guidelines and regulations. + Understanding of the implications of facility/group… more
- Regeneron Pharmaceuticals (Sleepy Hollow, NY)
- …commercialization activities, including the preparation of HTA submissions and addressing payer requirements. * Evaluate HTA decisions and apply insights to pipeline ... and marketed products, ensuring submissions meet regulatory and payer expectations for value demonstration and reimbursement. * Report, publish, and present HEOR… more
- Adecco US, Inc. (Utica, NY)
- …and appeals, ensuring timely patient access. 3. Design and deliver advanced payer insights tailored to provider needs, incorporating evolving policy trends and ... 7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights for stakeholders. 8.… more